cholestrol, cholesteral, cholestral, colesteral, cholestorol
Your blood cholesterol level has a lot to do with your chances of getting
heart disease. High blood cholesterol is one of the major risk factors for heart
disease. A risk factor is a condition that increases your chance of getting a
disease. In fact, the higher your blood cholesterol level, the greater your risk
for developing heart disease or having a heart attack. Heart disease is the
number one killer of women and men in the United States. Each year, more than a
million Americans have heart attacks, and about a half million people die from
heart disease.
When there is too much cholesterol (a fat-like substance) in your blood, it
builds up in the walls of your arteries. Over time, this buildup causes
"hardening of the arteries" so that arteries become narrowed and blood flow to
the heart is slowed down or blocked. The blood carries oxygen to the heart, and
if enough blood and oxygen cannot reach your heart, you may suffer chest pain.
If the blood supply to a portion of the heart is completely cut off by a
blockage, the result is a heart attack.
High blood cholesterol itself does not cause symptoms, so many people are
unaware that their cholesterol level is too high. It is important to find out
what your cholesterol numbers are because lowering cholesterol levels that are
too high lessens the risk for developing heart disease and reduces the chance of
a heart attack or dying of heart disease, even if you already have it.
Cholesterol lowering is important for everyone--younger, middle age, and older
adults; women and men; and people with or without heart disease.
Everyone age 20 and older should have their cholesterol measured at least
once every 5 years. It is best to have a blood test called a "lipoprotein
profile" to find out your cholesterol numbers. This blood test is done after a
9- to 12-hour fast and gives information about your:
- Total cholesterol
- LDL (bad) cholesterol--the main source of cholesterol buildup and blockage
in the arteries
- HDL (good) cholesterol--helps keep cholesterol from building up in the
arteries
- Triglycerides--another form of fat in your blood
If it is not possible to get a lipoprotein profile done, knowing your total
cholesterol and HDL cholesterol can give you a general idea about your
cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your
HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. See
how your cholesterol numbers compare to the tables below.
| Total Cholesterol Level |
Category |
| Less than 200 mg/dL |
Desirable |
| 200-239 mg/dL |
Borderline High |
| 240 mg/dL and above |
High |
* Cholesterol levels are measured in milligrams (mg) of
cholesterol per deciliter (dL) of blood.
| LDL Cholesterol Level |
LDL-Cholesterol Category |
| Less than 100 mg/dL |
Optimal |
| 100-129 mg/dL |
Near optimal/above optimal |
| 130-159 mg/dL |
Borderline high |
| 160-189 mg/dL |
High |
| 190 mg/dL and above |
Very high |
HDL (good) cholesterol protects against heart disease, so for HDL, higher
numbers are better. A level less than 40 mg/dL is low and is considered a major
risk factor because it increases your risk for developing heart disease. HDL
levels of 60 mg/dL or more help to lower your risk for heart disease.
Triglycerides can also raise heart disease risk. Levels that are borderline
high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some
people.
A variety of things can affect cholesterol levels. These are things you can
do something about:
Diet. Saturated fat and cholesterol in the food you eat make your
blood cholesterol level go up. Saturated fat is the main culprit, but
cholesterol in foods also matters. Reducing the amount of saturated fat and
cholesterol in your diet helps lower your blood cholesterol level.
Weight. Being overweight is a risk factor for heart disease. It also
tends to increase your cholesterol. Losing weight can help lower your LDL and
total cholesterol levels, as well as raise your HDL and lower your
triglyceride levels.
Physical Activity. Not being physically active is a risk factor for
heart disease. Regular physical activity can help lower LDL (bad) cholesterol
and raise HDL (good) cholesterol levels. It also helps you lose weight. You
should try to be physically active for 30 minutes on most, if not all, days.
Things you cannot do anything about also can affect cholesterol levels. These
include:
Age and Gender. As women and men get older, their cholesterol levels
rise. Before the age of menopause, women have lower total cholesterol levels
than men of the same age. After the age of menopause, women's LDL levels tend
to rise.
Heredity. Your genes partly determine how much cholesterol your body
makes. High blood cholesterol can run in families.
In general, the higher your LDL level and the more risk factors you have
(other than LDL), the greater your chances of developing heart disease or having
a heart attack. Some people are at high risk for a heart attack because they
already have heart disease. Other people are at high risk for developing heart
disease because they have diabetes (which is a strong risk factor) or a
combination of risk factors for heart disease. Follow these steps to find out
your risk for developing heart disease.
Step 1: Check the table below to see how many of the listed risk
factors you have; these are the risk factors that affect your LDL goal.
Major Risk Factors That Affect Your LDL Goal
- Cigarette smoking
- High Blood Pressure (140/90 mmHg or higher or on blood pressure
medication)
- Low HDL cholesterol (less than 40 mg/dL)*
- Family history of early heart disease (heart disease in father or brother
before age 55; heart disease in mother or sister before age 65)
- Age (men 45 years or older; women 55 years or older)
* If your HDL cholesterol is 60 mg/dL or higher, subtract 1
from your total count.
Even though obesity and physical inactivity are not counted in this list,
they are conditions that need to be corrected.
Step 2: How many major risk factors do you have? If you have 2 or more
risk factors in the table above, use the attached risk scoring tables
(Men - Women)
to find
your risk score. Risk score refers to the chance of having a heart attack in the
next 10 years, given as a percentage. My risk score is ________%.
Step 3: Use your medical history, number of risk factors, and risk
score to find your risk of developing heart disease or having a heart attack in
the table below.
| If You Have |
You Are in Category |
| Heart disease, diabetes, or risk score more than 20%* |
I. Highest Risk |
| 2 or more risk factors and risk score 10-20% |
II. Next Highest Risk |
| 2 or more risk factors and risk score less than 10% |
III. Moderate Risk |
| 0 or 1 risk factor |
IV. Low-to-Moderate Risk |
* Means that more than 20 out of 100 people in this category
will have a heart attack within 10 years.
My risk category is ______________________.
The main goal of cholesterol-lowering treatment is to lower your LDL level
enough to reduce your risk of developing heart disease or having a heart attack.
The higher your risk, the lower your LDL goal will be. To find your LDL goal,
see the boxes below for your risk category. There are two main ways to lower
your cholesterol:
Therapeutic Lifestyle Changes (TLC)--includes a cholesterol-lowering diet
(called the TLC diet), physical activity, and weight management. TLC is for
anyone whose LDL is above goal.
Drug Treatment--if cholesterol-lowering drugs are needed, they are used
together with TLC treatment to help lower your LDL.
If you are in...
-
Category I, Highest Risk, your LDL goal is less than 100 mg/dL. If
your LDL is 100 or above, you will need to begin the TLC diet. If your LDL is
130 or higher, you will need to start drug treatment at the same time as the
TLC diet. If your LDL is 100 to 129, you may also need to start drug treatment
together with the TLC diet. Even if your LDL is below 100, you should follow
the TLC diet on your own to keep your LDL as low as possible.
-
Category II, Next Highest Risk, your LDL goal is less than 130
mg/dL. If your LDL is 130 mg/dL or above, you will need to begin treatment
with the TLC diet. If your LDL is 130 mg/dL or more after 3 months on the TLC
diet, you may need drug treatment along with the TLC diet. If your LDL is less
than 130 mg/dL, you will need to follow the heart-healthy diet for all
Americans, which allows a little more saturated fat and cholesterol than the
TLC diet.
-
Category III, Moderate Risk, your LDL goal is less than 130 mg/dL.
If your LDL is 130 mg/dL or above, you will need to begin the TLC diet. If
your LDL is 160 mg/dL or more after you have tried the TLC diet for 3 months,
you may need drug treatment along with the TLC diet. If your LDL is less than
130 mg/dL, you will need to follow the heart-healthy diet for all
Americans.
-
Category IV, Low-to-Moderate Risk, your LDL goal is less than 160
mg/dL. If your LDL is 160 mg/dL or above, you will need to begin the TLC diet.
If your LDL is still 160 mg/dL or more after 3 months on the TLC diet, you may
need drug treatment along with the TLC diet to lower your LDL, especially if
your LDL is 190 mg/dL or more. If your LDL is less than 160 mg/dL, you will
need to follow the heart-healthy diet for all Americans.
To reduce your risk for heart disease or keep it low, it is very important to
control any other risk factors you may have such as high blood pressure and
smoking.
TLC is a set of things you can do to help lower your LDL cholesterol. The
main parts of TLC are:
-
The TLC Diet. This is a low-saturated-fat, low-cholesterol
eating plan that calls for less than 7% of calories from saturated fat and
less than 200 mg of dietary cholesterol per day. The TLC diet recommends only
enough calories to maintain a desirable weight and avoid weight gain. If your
LDL is not lowered enough by reducing your saturated fat and cholesterol
intakes, the amount of soluble fiber in your diet can be increased. Certain
food products that contain plant stanols or plant sterols (for example,
cholesterol-lowering margarines and salad dressings) can also be added to the
TLC diet to boost its LDL-lowering power.
-
Weight Management. Losing weight if you are overweight can
help lower LDL and is especially important for those with a cluster of risk
factors that includes high triglyceride and/or low HDL levels and being
overweight with a large waist measurement (more than 40 inches for men and
more than 35 inches for women).
- Physical Activity. Regular physical activity (30 minutes on
most, if not all, days) is recommended for everyone. It can help raise HDL and
lower LDL and is especially important for those with high triglyceride and/or
low HDL levels who are overweight with a large waist measurement.
|
Foods low in saturated fat include fat free or 1% dairy products,
lean meats, fish, skinless poultry, whole grain foods, and fruits and
vegetables. Look for soft margarines (liquid or tub varieties) that are
low in saturated fat and contain little or no trans fat (another type of
dietary fat that can raise your cholesterol level). Limit foods high in
cholesterol such as liver and other organ meats, egg yolks, and full-fat
dairy products.
Good sources of soluble fiber include oats, certain fruits (such as
oranges and pears) and vegetables (such as brussels sprouts and
carrots), and dried peas and
beans. |
Even if you begin drug treatment to lower your cholesterol, you will need to
continue your treatment with lifestyle changes. This will keep the dose of
medicine as low as possible, and lower your risk in other ways as well. There
are several types of drugs available for cholesterol lowering including statins,
bile acid sequestrants, nicotinic acid, and fibric acids. Your doctor can help
decide which type of drug is best for you. The statin drugs are very effective
in lowering LDL levels and are safe for most people. Bile acid sequestrants also
lower LDL and can be used alone or in combination with statin drugs. Nicotinic
acid lowers LDL and triglycerides and raises HDL. Fibric acids lower LDL
somewhat but are used mainly to treat high triglyceride and low HDL levels.
Once your LDL goal has been reached, your doctor may prescribe treatment for
high triglycerides and/or a low HDL level, if present. The treatment includes
losing weight if needed, increasing physical activity, quitting smoking, and
possibly taking a drug.
Keeping on Top of Your Condition
Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.
A new service available to patients provides a convenient means of staying informed, and ensures that the information is both reliable and accurate. If you wish to find out more about HealthNewsflash's innovative service, take the tour.
Framingham Point Scores by Age Group
| Age | Points |
| 20-34 | -9 |
| 35-39 | -4 |
| 40-44 | 0 |
| 45-49 | 3 |
| 50-54 | 6 |
| 55-59 | 8 |
| 60-64 | 10 |
| 65-69 | 11 |
| 70-74 | 12 |
| 75-79 | 13 |
Framingham Point Scores by Age Group and Total Cholesterol
| Total Cholesterol | Age 20-39 | Age 40-49 | Age 50-59 | Age 60-69 | Age 70-79 |
| <160 | 0 | 0 | 0 | 0 | 0 |
| 160-199 | 4 | 3 | 2 | 1 | 0 |
| 200-239 | 7 | 5 | 3 | 1 | 0 |
| 240-279 | 9 | 6 | 4 | 2 | 1 |
| 280+ | 11 | 8 | 5 | 3 | 1 |
Framingham Point Scores by Age and Smoking Status
| | Age 20-39 | Age 40-49 | Age 50-59 | Age 60-69 | Age 70-79 |
| Nonsmoker | 0 | 0 | 0 | 0 | 0 |
| Smoker | 8 | 5 | 3 | 1 | 1 |
Framingham Point Scores by HDL Level
| HDL | Points |
| 60+ | -1 |
| 50-59 | 0 |
| 40-49 | 1 |
| <40 | 2 |
Framingham Point Scores by Systolic Blood Pressure and Treatment Status
| Systolic BP | If Untreated | If Treated |
| <120 | 0 | 0 |
| 120-129 | 0 | 1 |
| 130-139 | 1 | 2 |
| 140-159 | 1 | 2 |
| 160+ | 2 | 3 |
10-Year Risk by Total Framingham Point Scores
| Point Total | 10-Year Risk |
| < 0 | < 1% |
| 0 | 1% |
| 1 | 1% |
| 2 | 1% |
| 3 | 1% |
| 4 | 1% |
| 5 | 2% |
| 6 | 2% |
| 7 | 3% |
| 8 | 4% |
| 9 | 5% |
| 10 | 6% |
| 11 | 8% |
| 12 | 10% |
| 13 | 12% |
| 14 | 16% |
| 15 | 20% |
| 16 | 25% |
| 17 or more | >30% |
Framingham Point Scores by Age Group
| Age | Points |
| 20-34 | -7 |
| 35-39 | -3 |
| 40-44 | 0 |
| 45-49 | 3 |
| 50-54 | 6 |
| 55-59 | 8 |
| 60-64 | 10 |
| 65-69 | 12 |
| 70-74 | 14 |
| 75-79 | 16 |
Framingham Point Scores by Age Group and Total Cholesterol
| Total Cholesterol | Age 20-39 | Age 40-49 | Age 50-59 | Age 60-69 | Age 70-79 |
| <160 | 0 | 0 | 0 | 0 | 0 |
| 160-199 | 4 | 3 | 2 | 1 | 1 |
| 200-239 | 8 | 6 | 4 | 2 | 1 |
| 240-279 | 11 | 8 | 5 | 3 | 2 |
| 280+ | 13 | 10 | 7 | 4 | 2 |
Framingham Point Scores by Age and Smoking Status
| | Age 20-39 | Age 40-49 | Age 50-59 | Age 60-69 | Age 70-79 |
| Nonsmoker | 0 | 0 | 0 | 0 | 0 |
| Smoker | 9 | 7 | 4 | 2 | 1 |
Framingham Point Scores by HDL Level
| HDL | Points |
| 60+ | -1 |
| 50-59 | 0 |
| 40-49 | 1 |
| <40 | 2 |
Framingham Point Scores by Systolic Blood Pressure and Treatment Status
| Systolic BP | If Untreated | If Treated |
| <120 | 0 | 0 |
| 120-129 | 1 | 3 |
| 130-139 | 2 | 4 |
| 140-159 | 3 | 5 |
| 160+ | 4 | 6 |
10-Year Risk by Total Framingham Point Scores
| Point Total | 10-Year Risk |
| < 9 | < 1% |
| 9 | 1% |
| 10 | 1% |
| 11 | 1% |
| 12 | 1% |
| 13 | 2% |
| 14 | 2% |
| 15 | 3% |
| 16 | 4% |
| 17 | 5% |
| 18 | 6% |
| 19 | 8% |
| 20 | 11% |
| 21 | 14% |
| 22 | 17% |
| 23 | 22% |
| 24 | 27% |
| 25 or more | > 30% |
|
